Polyaxial Bone Screw with Lateral Connector

ABSTRACT

A polyaxial screw body includes a side wall defining a lumen having a first end and a second end. An opening disposed at the first end of the lumen, includes an interior surface disposed in the side wall thereabout. The interior surface is adapted to accommodate a head portion of a pedicle screw. A transverse channel extends from a first aperture through the side wall to a second aperture and is adapted to accommodate a portion of a fixation rod therebetween. A lateral connector extending integrally from the side wall.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims priority to U.S. Provisional Patent ApplicationNo. 61/394,865, filed Oct. 20, 2010 and U.S. Provisional PatentApplication No. 61/411,303, filed Nov. 8, 2010, which are incorporatedherein by reference.

FIELD

The present invention relates generally to an apparatus for internalfixation of the spine and, more specifically relates to a polyaxialscrew body including a lateral connector integral with the screw bodyand useful for connecting the screw body to other components of a pelvicfixation device.

BACKGROUND

Certain spinal conditions, including a fracture of a vertebra and aherniated disc, indicate treatment by spinal immobilization. Severalmethods of spinal joint immobilization are known, including surgicalfusion and the attachment of pins and bone plates to the affectedvertebras. One known device is a bone interface anchor inserted into atleast two spaced-apart vertebras, with a stabilization rodinterconnecting the two or more anchors to stabilize the vertebrasspanned by the anchors.

During surgical implantation of these prior art stabilization systems,the surgical site is crowded with tissue masses, sponges, and othersurgical implements that obstruct access to the anchors. A challengewith current polyaxial screw systems is that lateral connectorstypically provide fixation between stabilization rods and a pelvic screwin a spinal construct. However, at the S1-L5 junction, it can beexceedingly difficult or impossible to attach an S1 pedicle screw, L5pedicle screw, and a lateral connector to a stabilization rod due tospecial limitations present at the S1-L5 junction. It has beendemonstrated that the integrity of the spinal construct is decreased ifeither the S1 or the L5 pedicle screw is not used. The present inventioncombines a polyaxial screw body with a lateral connector in a singledevice that ensures that all necessary fixation points can be achievedin a spinal construct at the S1-L5 junction.

For example, referring to FIG. 5, a portion of a human skeletonillustrates the Sacroiliac region and the L1-L5 and S1 vertebrae.Polyaxial pedicle screws 100 are shown attached to the pedicles of theL2-L4 vertebrae, polyaxial pedicle screws 102 are shown attached to theSacrum, and polyaxial pedicle screws 104 are shown attached to theIlium. A conventional polyaxial pedicle screw 106 is attached to onepedicle of the L5 vertebra. Stabilization rods 110 a and 110 b areillustrated vertically connecting the pedicle screws 100 and 102 oneither side of the vertebrae. Ideally, the polyaxial pedicle screw 104would be attached to the stabilization rod 110 a via a lateral connector112. However, at the S1-L5 junction, the polyaxial pedicle screw 106 mayinterfere with such connection, as indicated by arrow 114 in FIG. 5,thus making such connection problematic.

Thus, the present invention helps to alleviate a lack of space at theS1-L5 junction as compared to the prior art, allowing the surgeonadditional freedom in locating the anchors. The result is asignificantly improved polyaxial screw body.

SUMMARY

In one aspect of the present invention, a polyaxial screw body includesa side wall defining a lumen having a first end and a second end. Anopening disposed at the first end of the lumen, includes an interiorsurface disposed in the side wall thereabout. The interior surface isadapted to accommodate a head portion of a pedicle screw. A transversechannel extends from a first aperture through the side wall to a secondaperture and is adapted to accommodate a portion of a fixation rodtherebetween. A lateral connector extending integrally from the sidewall.

In other features, the lateral connector includes a hollow portion andis adapted to receive a member of a pelvic fixation device within thehollow portion. The lateral connector is threaded on an internal surfacethereof. The lateral connector is threaded on an external surfacethereof. The lateral connector is a member of a first sub-group ofpractically unique orientations that lie in planes generallyperpendicular to the transverse channel and generally parallel to acenterline of the lumen. The lateral connector is a member of a secondsub-group of practically unique orientations that lie in planesgenerally coplanar with a centerline of the lumen. The lateral connectoris a member of a third sub-group of practically unique orientations thatlie in planes that are non-coplanar with a centerline of the lumen andnon-perpendicular to the transverse channel. The lateral connector is amember of a curvilinear group of practically unique orientationsincluding curvature in one or more planes. The apertures compriseaxially extending slots, wherein each slot is open toward the secondend. The slots are smaller at an open end than at a closed end thereof.A locking cap releasably securable within the screw body and adapted tobear against the portion of the fixation rod accommodated by the slots.A bushing disposed within the screw body and adapted to be disposedbetween the head portion of a pedicle screw and a portion of a fixationrod.

In another aspect of the present invention, a polyaxial screw assemblyincludes a polyaxial screw with a proximal end with head and a distalend for attachment to a vertebra. A body member is defined by a sidewall and including a lumen having a proximal end and a distal end. Anopening at the distal end of the body member is configured to receivethe head of the polyaxial screw. A transverse channel is formed in theproximal end of the body member configured to accommodate a fixationrod. A lateral connector integral with the body member and extendsradially away from the side wall.

In other features, the lateral connector extends from the side wallwithin a first plane that is parallel to a centerline of the lumen andperpendicular to a plane formed by the centerline of the lumen and acenterline of the channel. The lateral connector extends from the sidewall within a second plane parallel to a centerline of the lumen andnon-perpendicular to a plane formed by the centerline of the lumen and acenter line of the channel. The lateral connector extends from the sidewall within a third plane coplanar with a centerline of the lumen. Thelateral connector extends from the side wall within a fourth plane thatintersects at least one of a centerline of the lumen and a plane formedby the centerline of the lumen and a centerline of the transversechannel. The lateral connector extends from the side wall in acurvilinear fashion within one or more planes. The lateral connectorextends from one of a proximal end of the side wall and a distal end ofthe side wall. The lateral connector extends from one of a first end ofthe side wall proximate to a first opening of the transverse channel anda second end of the side wall proximate to a second opening of thetransverse channel.

The foregoing summary, as well as the following detailed description ofthe preferred embodiments, will be understood when read in conjunctionwith the appended drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1A is a perspective view of an embodiment of a polyaxial screwbody.

FIG. 1B is an elevational view of the polyaxial screw body of FIG. 1A.

FIG. 1C is an elevational view of another embodiment of a polyaxialscrew body.

FIG. 2 is an end-on view, taken generally along the line 2 in FIG. 1B,of vertical planes passing through orientations of a lateral connectorrelative to a body member.

FIG. 3A is a perspective view of another embodiment of a polyaxial screwbody.

FIG. 3B is an elevational view of the polyaxial screw body of FIG. 3A.

FIG. 4 is an end-on view, taken generally along the line 4 in FIG. 3B,of orientations of a lateral connector relative to a body member.

FIG. 5 illustrates a spinal joint immobilization system affixed to ahuman Sacroiliac region and including a polyaxial pedicle screw of thecurrent invention.

DETAILED DESCRIPTION

As used herein, the term “longitudinal” refers to a direction orientedgenerally parallel to an imaginary centerline of a lumen disposedthrough a body member, as further described herein below. The terms“lateral” and “transverse” refer to being oriented generally in anydirection other than parallel to longitudinal.

Continuing with FIG. 5, a polyaxial pedicle screw 108 of the currentinvention is attached to the other pedicle of the L5 vertebra. Incontrast to the conventional polyaxial pedicle screw 106, the polyaxialpedicle screw 108 of the current invention includes a lateral connector116 extending integrally therefrom. The integrally extending lateralconnector 116 facilitates a proper connection between the stabilizationrod 110 b and the polyaxial pedicle screw 104 via the polyaxial pediclescrew 108.

An embodiment of an improved polyaxial screw body 300 comprises a bodymember 301 and a lateral connector 302 extending integrally from thebody member 301, as illustrated in FIGS. 1A and 1B. In one embodiment,the body member 301 includes a side wall 303 that defines a lumen 305disposed longitudinally through the body member 301 and having first andsecond ends proximate first and second ends 307, 309 of the body member301. In this embodiment, a pedicle screw 311 may extend from the lumen305 through an opening 313 at the second end of the lumen 305. Theopening 313 includes an interior surface disposed in the side wall 303thereabout. The interior surface is adapted to accommodate a headportion of the pedicle screw 311. In one embodiment, the opening 313includes a curvilinear interior surface disposed in the wall 303thereabout. The curvilinear interior surface may be adapted toaccommodate a head portion, for example, a spherical head portion of apedicle screw 311. An example of a body member 301 that may be useful inthe present invention is disclosed in Purcell et al., U.S. Pat. No.7,377,923, which is incorporated by reference in its entirety herein.

A channel 315 is defined by a pair of apertures 317, for example, holesor axially extending open ended slots 317 oppositely disposed throughthe side wall 303. The slots 317 include an open end facing the firstend 307 of the body member 301, as illustrated in FIGS. 1A, 1B, 2, 3A,3B, and 4, such that a fixation rod may be loaded into the slots 317from the open and accommodated therebetween. In one embodiment, theslots 317 are smaller at an open end than at a closed end thereof,thereby providing a snap fit and/or inhibiting removal of the fixationrod from the slots 317.

In another embodiment, the apertures 317 comprise holes 317, asillustrated in FIG. 1C. In this embodiment, a fixation rod is loadedinto the hole 317 along the channel 315.

All descriptions herein of relative orientations of the lumen 305 referto relative orientations of an imaginary centerline LC_(L) (See FIGS.1A, 1B, 3A, 3B, and 4) of the lumen 305. Similarly, all descriptionsherein of relative orientations of the channel 315 refer to relativeorientations of an imaginary centerline CC_(L) (See FIGS. 1A, 1B, 2, 3B,and 4) disposed through the pair of apertures 317. Further, alldescriptions herein of relative orientations of the lateral connector302 (or any other lateral connectors as described herein below) refer torelative orientations of an imaginary centerline OC_(L) (See FIGS. 1A,1B, 3A, and 3B) of the lateral connector 302 (or any other lateralconnectors as described herein below). The channel 315 is orientedtransverse and generally perpendicular to the lumen 305. The lateralconnector 302 may include various orientations relative to the lumen 305and the channel 315 of the body member 301.

The utility of the polyaxial screw body 300 benefits from a medicalprofessional's ability to select the orientation of the lateralconnector 302 relative to the body member 301. Given the crowding of thesurgical site, a particular orientation of the lateral connector 302relative to the body member 301 may be superior to other orientations ofthe lateral connector 302 relative to the body member 301. Thus,providing the medical professional a choice from a spectrum oforientations not only increases the utility of the screw body 300, butalso allows the medical professional to provide optimal care to apatient by selecting the optimum relative orientation of the lateralconnector 302.

Referring to FIG. 2, the body member 301 is viewed end on from the firstend 307. Mathematically, an infinite number of orientations of a linecan be encompassed in planes generally parallel to the centerline LC_(L)of the lumen 305. Each line 314, 316, 318, 320, 322, 324, 326, 328, 330having arrows at ends thereof in FIG. 2 represents a possibleorientation of the line OC_(L) line relative to the lumen 305. Note thatall illustrated orientations of the lines 314, 316, 318, 320, 322, 324,326, 328, 330 lie in planes generally parallel to the lumen 305. Infact, mathematically, all possible orientations of the line OC_(L)relative to the lumen 305 necessarily lie in planes generally parallelto the lumen 305. This can be visualized by simply passing a planecoincident with each of the possible orientations perpendicularly intothe paper of FIG. 2.

However, because there are limits on tolerances achievable in themanufacture of parts, and because the lateral connector 302 has a finitesize, the number of orientations that are practically different from oneanother in planes generally parallel to the lumen 305 is not infinite. Aplanar group 400 of orientations can be defined to include allpractically unique orientations of the lateral connectors 302 that liein planes generally parallel to the lumen 305. The planar group 400includes all the orientations represented by the lines 314, 316, 318,320, 322, 324, 326, 328, 330 illustrated in FIG. 2.

A first sub-group 402 of the planar group 400 of orientations of thelateral connector 302 includes all practically unique orientations thatlie in planes that are generally perpendicular to a plane formed by thecenterline CC_(L) of the transverse channel 315 and the centerlineLC_(L) of the lumen 305 and generally parallel to the lumen 305.Referring to FIG. 2, lines 314, 316, and 318 each represent an exampleof an orientation of the lateral connector 302 that lies in a plane thatis generally perpendicular to the transverse channel 315 and generallyparallel to the lumen 305. Thus, the lines 314, 316, and 318 are membersof the first sub-group 402.

Referring to FIGS. 1A and 1B, in this embodiment, the lateral connector302 extends from the side wall 303 in a plane that is generallyperpendicular to the transverse channel 315 and generally parallel tothe lumen 305. The lateral connector 302 extends in a direction that isgenerally perpendicular to a plane formed by the centerline LC_(L) ofthe lumen 105 and the centerline CC_(L) of the channel 315. Therefore,in this embodiment, the lateral connector 302 is a member of the firstsub-group 402 of the planar group 400 of orientations. The lateralconnector 302 is integral with the side wall 304 and is adapted toattach to a member of a pelvic fixation device.

In one embodiment, the lateral connector 302 is partially hollow,whereas in other embodiments the lateral connector 302 is a tubular orsolid member. The lateral connector 302 may be threaded on a portionthereof, for example, a distal end thereof, as illustrated in FIG. 1B,or over an entirety thereof as known in the art. Threads 304 may beapplied to an exterior surface 306 or an interior surface of the lateralconnector 302. The lateral connector 302 may include other connectionmechanisms such as, for example, a bayonet socket connection, a springloaded button and aperture connection, a cotter pin connection, andothers as may be known in the art. The lateral connector 302 may haveany cross-sectional shape as known in the art, including by way ofexample and not limitation, circular, elliptical, ovoid, or polygonalincluding any number of straight line or curvilinear sides.

Referring to FIG. 1B, the lateral connector 302 may extend from the bodymember 301 from anywhere along a longitudinal extent of the body member301 from the first end 307 to the second end 309. For example, thelateral connector 302 may extend from the body member 301 proximate thefirst end 307 or proximate the second end 309, as illustrated by thedashed lines 308, 310, respectively in FIG. 1B, or anywhere in betweenthe first and second ends 307, 309, as illustrated, for example, at 312.Each orientation 308, 310, 312 of the lateral member 302 lies in a planethat is generally perpendicular to the transverse channel 315 andgenerally parallel to the lumen 305, and thus within the first sub-group402 of orientations.

Referring to FIGS. 3A and 3B, in another embodiment of a polyaxial screwbody 350, a lateral connector 302 extends from the side wall 303 in anorientation 332 in a plane that is generally perpendicular to thetransverse channel 315 and generally parallel to the lumen 305. In thisorientation 332, the lateral connector 302 extends away from the bodymember 301 generally towards the first end 307. The lateral connector332 may extend from the polyaxial screw body 350 in a directionrelatively toward the first end 307 or relatively toward the second end309 from anywhere along the length of the body member 301 from the firstend 307 to the second end 309, as illustrated by the dashed lines 336,338 in FIG. 3B. Therefore, each orientation 332, 336, and 338 of thelateral connector 302 lies in a plane that is generally perpendicular tothe transverse channel 315 and generally parallel to the lumen 305, andthus within the first sub-group 402 of orientations. Further, the firstsub-group 402 of orientations includes lateral connectors 302 thatextend from the body member 301 from proximate a first end 317 a of thechannel 315, proximate a second end 317 b of the channel 315, oranywhere in between the first and second ends of the channel 315, asrepresented by the lines 314, 318, and 316, respectively, as shown inFIG. 2.

Referring to FIG. 3B, the lateral connector 302 is illustrated by dashedlines 334 as having a curvilinear orientation in at least one plane. Forexample, if the orientation 334 was curved in only the plane of thepaper (including a distal end 335, as illustrated in FIG. 3B), theorientation 334 would lie entirely in a plane that is generallyperpendicular to the transverse channel 315 and generally parallel tothe lumen 305, thus making the orientation 334 a member of the firstsub-group 402.

However, if the orientation 334 includes a curve into or out of theplane of the paper (including a distal end 337, as illustrated in FIG.3B), the orientation 334 would lie in more than a single plane and wouldtherefore belong to a group of practically unique orientations that isexternal to the planar group 400, which we shall call the curvilineargroup 500. Each member of the curvilinear group 500 may extend from thebody member 301 from any position relative to the transverse channel315, for example, as illustrated by lines 314, 316, and 318 of FIG. 2,or any position along a longitudinal extent of the body member 301 fromthe first end 307 to the second end 309 (See FIGS. 1B and 3B).

Referring to FIG. 2, a second sub-group 404 of the planar group 400 oforientations of the lateral connector 302 includes those that aregenerally co-planar with the lumen 305, but not necessarily generallyperpendicular to the transverse channel 315. The lines 316 and 330 liein planes that include the lumen 305, thus, the lines 316 and 330represent orientations that are part of the second sub-group 404.Referring to FIGS. 1B and 2, note that orientations represented by thedashed lines 308 and 310, and the lines 312 and 316 are members of boththe first sub-group 402 and the second sub-group 404. The remaininglines, 320, 322, 324, 326, and 328 illustrated in FIG. 2 lie in planesthat are neither generally co-planar with the lumen 305 nor generallyperpendicular to the transverse channel 315, and thus representorientations that are members of a third sub-group 406 of the planargroup 400.

Referring to FIG. 4, another embodiment of a polyaxial screw body 375includes a lateral member, such as for example, any of the lateralmembers 377, 379, 381, or 383. Each of the lateral members 377, 379,381, or 383 may extend from the body member 301 from any positionrelative to the transverse channel 315, for example, as illustrated bylines 314, 316, and 318 of FIG. 2, or any position along a longitudinalextent of the body member 301 from the first end 307 to the second end309 (See FIGS. 1B and 3B). Further, as illustrated by curved line 385,the lateral members 377, 379, 381, 383 may have any rotationalorientation relative to the transverse channel 315.

The lateral members 377, 379, 381, 383 may extend from the body member301 at any angle relative to the lumen 305. The lateral connectors 377,379, 381, 381, are part of the third sub-group 406 of practically uniqueorientations including members that lie in a plane generally parallel tothe lumen 305, but are not generally co-planar with the lumen 305 orgenerally perpendicular to the transverse channel 315. Note thatorientation 387 represented by dashed lines is not a member of the thirdsub-group 406, but is a member of the first sub-group 402 and the secondsub-group 404.

The groups of practically unique orientations presented hereinaboveprovide a convenient way to classify all of the possible practicallyunique orientations of the lateral connector 302 relative to the bodymember 301. A global group comprising of all orientations would includethe curvilinear group 500 and the planar group 400 as sub-groupsthereof. The planar group 400 includes the first, second, and thirdsub-groups 402, 404, 406, as defined hereinabove. Note that there arepractically unique orientations that are members of both the first andsecond sub-groups 402 and 404.

The lateral connectors 302 may integrally extend from the body member301 in any of the practically unique orientations described hereinaboveand the polyaxial screw bodies 300, 350, 375 may be manufactured frommethods as known in the art, including by way of example and notlimitation, casting, machining, or combinations of casting andmachining. Material for the polyaxial screw bodies 300, 350, 375 may bea suitable material as known in the art, including by way of example andnot limitation stainless steel, Nitinol or titanium, stainless steel,other shape memory metal materials, other metals, plastic, syntheticmaterial, other suitable materials, or any combination thereof. Becausethe sub-groups 402, 404, 406, and the curvilinear group 500 definedhereinabove refer to groups of practically unique orientations and notgroups of mathematically possible orientations, each of the sub-groups402, 404, 406, and the curvilinear group 500 does not include aninfinite number of members. Rather, because the number of practicallyunique orientations is limited by the finite size and shape of the bodymember 301 and the lateral member 302 and the tolerances of modernmanufacturing techniques, each of the sub-groups 402, 404, 406, and thecurvilinear group 500 includes a finite, albeit large, number ofmembers.

An improved polyaxial screw body is presented. A lateral connectorintegrally extends from a body member of the polyaxial screw body toutilize less space than a conventional polyaxial screw body utilizing aconventional fixation rod connector. The lateral connector mayintegrally extend from the body member in any orientation as desired toprovide a medical professional a choice in selection of the optimumorientation.

It will be appreciated by those skilled in the art that changes could bemade to the embodiments described hereinabove without departing from thebroad concepts disclosed therein. It is understood, therefore, that thisdisclosure is not limited to the particular embodiments disclosed, butit is intended to cover modifications that may include a combination offeatures illustrated in one or more embodiments with featuresillustrated in any other embodiments. Various modifications, equivalentprocesses, as well as numerous structures to which the presentdisclosure may be applicable will be readily apparent to those of skillin the art to which the present disclosure is directed upon review ofthe present specification. Accordingly, this description is to beconstrued as illustrative only and is presented for the purpose ofenabling those skilled in the art to make and use the polyaxial screwbody described herein and to teach the best mode of carrying out thesame.

The invention claimed is:
 1. A body member of a spinal screw forreceiving a fixation rod, comprising: a side wall forming a lumen in aproximal end that is configured to receive the spinal fixation rod and asetscrew and a distal end that is configured to couple with the spinalscrew; a transverse channel extending from a first aperture in the sidewall to a second aperture in the side wall that is configured to permitpassage of the fixation rod therethrough; and a lateral connectorincluding a tubular shape integral with the side wall and extending awayfrom the side wall at an angle relative to the transverse channel. 2.The body member of claim 1, wherein the lateral connector extends fromthe side wall within a first plane that is parallel to a centerline ofthe lumen and perpendicular to a plane formed by the centerline of thelumen and a centerline of the transverse channel.
 3. The body member ofclaim 1, wherein the lateral connector extends from the side wall withina second plane parallel to a centerline of the lumen andnon-perpendicular to a plane formed by the centerline of the lumen and acenter line of the transverse channel.
 4. The body member of claim 1,wherein the lateral connector extends from the side wall within a thirdplane coplanar with a centerline of the lumen.
 5. The body member ofclaim 1, wherein the lateral connector extends from the side wall withina fourth plane that intersects at least one of a centerline of the lumenand a first plane formed by the centerline of the lumen and a centerlineof the transverse channel.
 6. The body member of claim 1, wherein thelateral connector extends from the side wall in a curvilinear fashionwithin one or more planes.
 7. The body member of claim 1, wherein thelateral connector extends from one of the proximal end of the side walland the distal end of the side wall.
 8. The body member of claim 1,wherein the lateral connector extends from one of a first end of theside wall proximate to the first aperture and a second end of the sidewall proximate to the second aperture.
 9. The body member of claim 1, incombination with the spinal screw, the spinal screw including a pediclescrew with a head portion at a proximal end received by the distal endof the side wall and a threaded portion at a distal end for attachmentto a lumbar vertebra.
 10. The body member of claim 9, in combinationwith a sacral screw assembly further comprising: a sacral screw with asecond head portion at a proximal end and a second threaded portion at adistal end for attachment to a sacrum; and a second body member definedby a second side wall forming a second lumen in a proximal end that isconfigured to receive the lateral connector and a second setscrew, adistal end that receives the second head portion, and a secondtransverse channel in the proximal end that extends from a firstaperture in the second side wall to a second aperture in the second sidewall configured to permit passage of the lateral connector therethrough.11. A sacral to lumbar fixation system comprising: a pedicle screw witha first head portion at a proximal end and a first threaded portion at adistal end for attachment to a lumbar vertebra; a first body memberdefined by a first side wall forming a first lumen in a proximal endthat is configured to receive a fixation rod and a first setscrew and adistal end that is configured to couple with the first head portion ofthe pedicle screw, a first transverse channel in a proximal endextending from a first aperture in the first side wall to a secondaperture in the first side wall that is configured to permit passage ofthe fixation rod therethrough, and a lateral connector including atubular shape integral with the first side wall and extending away fromthe first side wall at an angle relative to the first transversechannel; a sacral screw with a second head portion at a proximal end anda second threaded portion at a distal end for attachment to a sacrum;and a second body member defined by a second side wall forming a secondlumen in a proximal end that is configured to receive the lateralconnector and a second setscrew, a distal end that receives the secondhead portion, and a second transverse channel in the proximal end thatextends from a first aperture in the second side wall to a secondaperture in the second side wall configured to permit passage of thelateral connector therethrough.
 12. The system of claim 11, wherein thelateral connector extends from the first side wall within a first planethat is parallel to a centerline of the first lumen and perpendicular toa plane formed by the centerline of the first lumen and a centerline ofthe first transverse channel.
 13. The system of claim 11, wherein thelateral connector extends from the first side wall within a second planeparallel to a centerline of the first lumen and non-perpendicular to aplane formed by the centerline of the first lumen and a center line ofthe first transverse channel.
 14. The system of claim 11, wherein thelateral connector extends from the first side wall within a third planecoplanar with a centerline of the first lumen.
 15. The system of claim11, wherein the lateral connector extends from the first side wallwithin a fourth plane that intersects at least one of a centerline ofthe first lumen and a first plane formed by the centerline of the firstlumen and a centerline of the first transverse channel.
 16. The systemof claim 11, wherein the lateral connector extends from the first sidewall in a curvilinear fashion within one or more planes.
 17. The systemof claim 11, wherein the lateral connector extends from one of theproximal end of the first side wall and the distal end of the first sidewall.
 18. The system of claim 11, wherein the lateral connector extendsfrom one of a first end of the first side wall proximate to the firstaperture and a second end of the first side wall proximate to the secondaperture.
 19. The system of claim 11, wherein the lateral connectorextends radially away from the first side wall.
 20. The system of claim11, wherein the lateral connector extends tangentially away from thefirst side wall.